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Colorectal stapled anastomoses. Experiences and results
O Hansen1, W Schwenk, H P Hucke
1Department of Surgery, Marien-Hospital Dusseldorf, Dusseldorf, Germany.
Diseases of the Colon and Rectum
|January 1, 1996
Summary
This study shows that using circular staplers for rectal anastomoses in colorectal surgery is safe and effective, with low complication rates. Stapled techniques simplify rectal surgery, often eliminating the need for protective colostomy.
Area of Science:
- Colorectal Surgery
- Surgical Techniques
- Anastomosis
Background:
- Stapled anastomoses are an established technique in colorectal surgery.
- Larger series on the routine clinical use of circular staplers in rectal anastomoses are infrequent.
Purpose of the Study:
- To evaluate the morbidity, clinical leakage rate, and mortality associated with stapled rectal anastomoses.
- To assess the efficacy of circular staplers in routine colorectal surgery.
Main Methods:
- A retrospective analysis of 615 elective, left-sided colorectal resections with stapled rectal anastomoses.
- Intraoperative liquid instillation testing of all anastomoses.
- Exclusion of manually sewn rectal anastomoses.
Main Results:
- A total of 615 procedures were performed by 18 surgeons between 1984 and 1993.
- Clinical anastomotic leakage occurred in 1.5% (n=9) of patients.
- The mortality rate was 1% (n=6), with protective colostomy used in 2.9% (n=16).
Conclusions:
- Stapling techniques facilitate rectal anastomosis, especially in challenging anatomical locations.
- The low rate of local complications suggests protective colostomy can be avoided in most cases.
- Circular staplers are a safe and effective option for rectal anastomoses in routine clinical practice.